Blood antibody screen
Facility: Wesley Medical Center
Billing Code: 86850 (CPT)
- CPT Billing Code: 86850
- Insurance Median: $20
- Cash Discount Price: $524
- vs. Medicare Baseline: 0.38x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $53.24 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $8 | 15% |
| Amerigroup | $9 | 17% |
| Aetna | $9 - $187 | 17% |
| Medicaid / KanCare | $9 | 17% |
| Devoted Health | $10 | 19% |
| Humana | $10 | 19% |
| Coventry Health Care | $10 | 19% |
| Ambetter / Centene | $10 - $94 | 19% |
| United | $10 - $236 | 19% |
| Correct Care Solutions | $15 | 28% |
| First Health | $17 - $242 | 32% |
| Multiplan | $17 - $472 | 32% |
| Blue Cross Blue Shield | $20 | 38% |
| Wppa | $91 | 171% |
| Health Partners Of Kansas | $91 - $262 | 171% |
| Preferred Health Choices | $99 | 186% |
| Medical Associates Health Plan | $99 | 186% |
| Spirit Aerosystems | $168 | 316% |
| Triwest Healthcare Alliance | $341 | 640% |
| Usa Managed Care | $445 | 836% |
Consumer Guidance & Cost Commentary
For this blood antibody screen at Wesley Medical Center in Wichita, KS, the cash price is $524.00, which matches the facility's median paid amount. This rate is significantly higher than the Medicare benchmark of $53.24, reflecting a markup common in commercial healthcare. While the facility lists a median negotiated rate of $20.00, this figure represents the average amount commercial insurers pay across their contracts, not a guaranteed price for every patient. Patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $524.00, as paying out-of-pocket could result in lower total costs. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates vary widely by carrier and can sometimes be substantially higher than the cash price.
To ensure you receive the most accurate billing, always request an itemized bill before paying. Hospitals often issue summary invoices that obscure individual charges, which can hide errors or unbundled codes that should be consolidated. If you receive a bill, dispute any discrepancies in writing to the billing supervisor rather than accepting the summary as final. Additionally, ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the $524.00 cash price by 20% to 50% if paid in full upfront. These discounts bypass the administrative costs associated with insurance claims and provide immediate liquidity to the facility. Finally, be aware of federal protections under the No Surprises Act, which prohibit balance billing for out-of-network services at in-network facilities, ensuring you are not billed for the difference between the provider's full charge and your insurance payment.